Wednesday, April 4, 2007

"Shortness of Breath", Increased Activity & Exercise

Welcome back to "My Little Corner Of The World"! It's been awhile since I have posted, but I hope you all have been taking care of yourselves and breathing well.
This will be the first post in a so-called "mini series" on the topic of "Shortness of Breath" & Exercise. In our first "episode" you will have limited activity and breathing abilities, but as we reach the end of our "mini series" you will have learned a new way to breathe and will be on your way to an exercise training program.

The shortness of breath that comes with COPD typically limits a persons ability to be active. Understandably, you would think that becoming involved in an exercise program would be out of the question.
You probably have realized a gradual reduction in the activities you enjoy that involve any type of physical effort. And even if your COPD is only moderately severe you probably have noticed a redution in your "Quality of Life in Daily Living". I'm sure you have attributed this decline to your dyspnea, which is correct. But, this decline in your exertin ability is much more complicated.

Next is what I call, a "vicious circle". Exertion requires muscular effort, and muscular effort requires a steady supply of Oxygen, which is an essential metabolic source of energy. And muscular effort also produces waste products of metabolism, which is Carbon Dioxide ("CO2") which the lungs must dispose of. Are you still with me?... Okay... The lungs are critically important in taking in Oxygen and getting rid of waste Carbon Dioxide. Your breathing impairment will certainly limit your Oxygen delivery and CO2 excretion.
However, Oxygen and CO2 are carried to and from the muscles by your blood, now if your heart muscle becomes deconditioned by inactivity or diseae and can't pump blood efficiently, this may be a significant factor to your limited exertion capabilities.

Then there are peripheral muscles, the external muscles, mainly the legs and arms and whether or not they are efficiently receiving Oxygen and producing their required energy. Unfortunately, perfectly normal muscles, can become deconditioned by inactivity and become inefficient at the cellular level in producing the required oxygen for activity. Severely deconditioned muscles are very inefficient in processing this important oxygen metabolic energy, and muscle deconditioning is frequently a serious limitation to activity for the person with COPD. These deconditioned muscles require more Oxygen and give up more CO2 for a given work load, which brings on an even greater burden to the lung and heart components of this overall complex system.

The person with COPD progressively limits their activity because of exertin related dyspnea. As a result of this decreased activity, the heart then becomes deconditioned, and becomes a less efficient pump that has to work harder to achieve the same task level. Fortunately cardiac funtion limitation is usually not a major problem. But improving cardiac performance with an exercise program will provide some help to your overall exercise capabilities.

Peripheral muscle, the muscles of the arms and legs... deconditioning is a major culprit leading to severe weakness in COPD. Do you remember the "vicious circle"I spoke about earlier?... where inactivity leads to deconditioning and deconditioning leads to muscular weakness and inefficiency, which in turn now requires more effort by the heart and lungs for the same level of muscular effort.

Well, I think that is a very good start in explaining to COPD patients that activity and exercise beginning in slow moderation will condition not only your muscles in your arms and legs, but will keep your heart from working overtime due to the lack of oxygen from your diseased lungs.

Until next time,
Breathe well my friends...
1 2 3... Inhale ... 1 2 3 4... Exhale,
Sandy

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